Q: We have been trying to have a baby for two years. My gynecologist says that I am fine. My husband is a macho athlete who says the problem just can’t be him. He tells me, “strong body, strong sperm.”

A: Fertility problems affect 15 percent of all couples. One factor often overlooked is excess heat, which can slow down or damage sperm. Men who take long hot showers or hot Jacuzzi can be impairing their semen count. That is the origin of the recommendation for men to wear loose underwear. Tight underwear or athletic equipment can increase heat in this part of the body that is incredibly heat sensitive.

Another factor is steroids. Even one cycle of steorids can throw the fertility potential off for months, years or even longer. Then there’s testosterone. Many people equate testosterone with manhood and think that extra testosterone can be helpful for their sperm. The opposite is true.

The first step for your macho husband is to have his sperm checked, and if there are any concerns than a hormone check would be next. If he is resistant, remind him that it takes a man and woman to make a baby. And I think we are all very grateful for that.